I can just imagine that this is what someone with dementia is saying in his/her mind as his/her mouth can’t seem to find the right words in the precise moment that a caregiver is passing by.
How many times have you passed this individual on a couch at home, in an Assisted Living hallway, or in a Nursing Home doorway? You know this person. S/he is the one who is reaching out and grabbing at you or yelling, “Hey, hey” or “Help, help.” And what is our unfortunate tendency when this happens? To ignore them and hope that the behavior goes away. And this is exactly what we should NOT do!
But wait…isn’t this what all of the experts said in our child-rearing days? “When your two year old is throwing a temper tantrum, don’t pay attention to her/him. S/he will soon learn that s/he cannot act this way for attention.”
BUT these individuals are NOT children, they are NOT two year olds, they are NOT throwing a temper tantrum, they do NOT realize what they are doing, and they are NOT in a position of “learning”! They are trying to communicate. There is a need there that is not being fulfilled and if we ignore it, the behavior will only GET WORSE. Naomi Feil teaches it best in Validation when she states, “The cat ignored becomes the tiger.”
Jim Evans stated, “Another way to lose control is to ignore something when you should address it.” And this is never more true than when you are working with someone with dementia. Consider the following actual scenario:
One particular Friday morning, the CNA’s at our third floor Memory Care Unit were gathering residents and readying them for the van ride. Many of the residents looked forward to the van ride and among them were Bill and Ellie, a very attached-to-each-other married couple in their mid 90’s. Just as the van pulled around and the elevator was being summoned to the floor, Bill decided that he suddenly needed to use the bathroom. He summoned a CNA who wheeled him into the nearest bathroom to help him take care of business.
While Bill was in the bathroom, another CNA wheeled Ellie into the elevator and took her downstairs as one of the first group of residents to go down to the van. Shortly afterward, Bill was wheeled out of the bathroom and situated in front of the elevator as they waited for it to return. Bill immediately looked around and began to look anxious. The CNA’s, in the busyness of attempting to round up residents and get them onto the elevator, did not notice Bill’s demeanor as he began reaching out to the caregivers in an attempt to say something.
One CNA said, “Come on, Bill…let’s get on the elevator now.” But Bill refused. Again, Bill attempted to get someone’s attention, but this CNA was intent on loading the elevator and grabbed Bill’s wheelchair and began to push it. Bill put his feet down and simply said, “No.” Another CNA came and attempted to get Bill to agree to get on the elevator. Bill became even more frantic and this time, he yelled, “NO!” The first CNA re-approached Bill and politely, but firmly insisted that he get in the elevator and she began pushing the wheelchair into the elevator. This time, Bill planted his feet, pushed himself up out of the wheelchair into a standing position and yelled, “Goddamnit! Where’s my wife?!”
How different would this scenario have been had the first CNA not ignored Bill’s attempts at getting her attention? Had she simply stopped and asked Bill what his concern in getting on the elevator was, she would have been able to avoid the entire situation. She could have calmly explained to him that Ellie was already downstairs and on the van. And, even more importantly, Bill never would have had to get upset and yell in order to get his needs met.
So…the next time you walk by a demented individual who is trying to get your attention, remember that this is a human being with human needs and emotions, that it’s no fun being ignored, and that you may just be the one who keeps that cat from becoming a tiger.